The face: Muscles of the

face. Nerves and superficial

vasculature of the face
Dr Okeke Emmanuel
Outline
• Introduction
• Muscles of the face
• Nerve supply of the face
• Superficial vasculature of the face
• Conclusion
Introduction
• The face contains a complex network of muscles, nerves and blood
vessels that facilitate facial expressions, sensation and circulation.

• Understanding these structures is essential for clinical appplications in

neurology, facial surgery and trauma management .
 Face
• Extends superiorly to the hair line, inferiorly to
the chin and base of mandible, and on each side
to auricle
• Forehead is common to both scalp and face.
• It is very vascular and the skin is rich in
sebaceous gland and sweat gland.
• Wounds of face bleed profusely but heal rapidly.
• Sebaceous gland keep the skin oily but also cause
acne in adult.
• Contains muscles of facial expression and lie in
superficial fascia.
• Embryologically they develop from mesoderm
of 2nd pharyngeal arch, therefore they are
supplied by facial nerve.
• No deep fascia is present in the face.
Muscles of the face
• The muscles of the face can be generally grouped into two

1. Muscles of facial expression (Mimetic muscles)

2. Muscles of mastication

• Muscles of facial expression develops from the second branchial arch

and the nerve of the second branchial arch is………
• Muscles of mastication develop from the first branchial arch and the
nerve supply of that arch is ……..
Muscles of facial expression
• These are a group of superficial “skeletal muslces” loated within the
subcutaneous tissue of the face. They primarily originate from bones
of the face or fascia and insert directly into the skin, allowing them to
produce various facial expression.

• Unlike other skeletal muscles, these muscles do not act across joints
but move the skin and modify facial features.
• The muscles of facial expression can be grouped based on their
location and function:

1. Scalp and eyelid muscles

2. Nasal muscles
3. Oral muscles
4. Auricular and cervical muslces
Scalp and eyelid muscles
1. Occipitofrontalis (Epicranius)
• Origin: Two bellies.
• Frontal belly arises from the skin and superficial fascia of eyebrows.
• Occipital belly arises grom the lateral two third of the superior nuchal line
• Insertion: Epicranial aponeurosis (galea aponeurotica)
• Action: raised eyebrows, wrinkles the forehead
• Nerve supply: temporal branch (frontal belly) and Posterior auricular
branch (occipital belly) of facial nerve (CN VII)
Scalp and eyelids muscles - 2
2. Orbicularis oculi
• Parts:
• Orbital part
• Palpebral part
• Lacirmal part
• Origin: Medial orbital margin and medial palpebral ligament
• Insertion: Skin around the eyelid and lateral palpebral raphe
• Action: Closes eyelids (blinking, squinting). Protrect eyeballs from injury and
keep the cornea moist by spreading tears.
• Nerve supply: temporal branch and zygomatic branches of facial nerve (CN
VII)
Orbicularis oculi
• Orbital part (outer)
• Originate from medial part of medial
palpebral ligament and form concentric
rings.
Action - closes the lids tightly
• Palpebral part (Inner)
• Originate from lateral part of medial
palpebral ligament
• Insert into lateral palpebral raphe
Action - closes the lids gently
• Lacrimal part (Small)
• Originate from lacrimal fascia & lacrimal
bone
• Insert into upper & lower tarsi
Action - dilate lacrimal sac
• When all three parts of the orbicularis oculi contract,
the eyes are firmly closed.
Orbicularis oculi
Scalp and eyelid muscles - 3
3. Corrugator supercilli
• Origin: Medial end of the
supercillary arch
• Insertion: Skin of the eyebrow
• Action: Draws eyebrows medially
(frowning)
• Nerve supply: temporal branch
of facial nerve (CN VII)
Nasal muscles

1. Procerus
• Origin: Nasal bone and upper lateral
nasal cartilage.
• Insertion: Skin of the forehead between
eyebrows
• Action: wrinkles skin over nose
(displeasure expression)
• Nerve supply: temporal and zygomatic
branches of facial nerve (CN VII)
Nasal muscle - 2
2. Nasalis
• Parts:
• Transerves part (Compressor naris):
Compresses nostrils
• Alar part (Dliator naris): flares nostrils
• Origin: Maxilla (near nasal notch)
• Insertion: Aponeurosis at nasal bridge
(transverse) and alar cartilage (alar)
• Action: Narrows or widens nostrils
• Nerve supply: Buccal branche of facial
nerve (CN VII)
Nasal Muscles - 3
3. Depressor septi Nasi
• Origin: Maxilla (near incisive fossa).
• Insertion: Nasal septum and alar of nose.
• Action: Pulls nose inferiorly (assists in flaring of nostrils).
• Nerve supply: Buccal branche of facial nerve (CN VII)
Oral muscles
1. Orbicularis Oris
• Origin: Modiolus (fibromusclar structure at mouth angle)
• Insertion: Encircles mouth, inserts into lips and skin
• Action: closes and protrudes lips (whistling)
• Nerve supply: Buccal and mandibular branches of facial nerve (CN VII)
Orbicularis Oris
Oral muscles - 2
1. Buccinator
• Origin: Modiolus (fibromusclar structure at mouth angle)
• Insertion: Encircles mouth, inserts into lips and skin
• Action: closes and protrudes lips (whistling)
• Nerve supply: Buccal and mandibular branches of facial nerve (CN VII)
 Oral muscles - 2
2. Buccinator

• Upper fibers
• Origin- from maxilla opposite molar teeth
• Insertion-upper lip
• Lower fibers
• Origin-from mandible opposite molar teeth
• Insertion-lower lip
• Middle fibers
• Origin –from pterigomandibular raphe
• Insertion-decussate before passing to lips
• Action- it aids in mastication by prevent
accumulation of food in vestibule of mouth. It is used
every time air expanding the cheeks is forcefully
expelled
Oral Muscle - 3
3. Levator labii superioris
• Origin: Maxilla (infraorbital margin)
• Insertion: Upper lip skin and orbicularis oris
• Action: Elevates upper lip
• Nerve supply: Zygomatic and Buccal branchesof facial nerve (CN VII)
Oral muscles - 4
4. Depressor labii inferioris
• Origin: Mandible (oblique line)
• Insertion: Lower lip skin and orbicularis oris
• Action: depresses lower lip
• Nerve supply: Mandibular branch of facial nerve (CN VII)
4. Mentalis
• Origin: Mandible (incisive fossa)
• Insertion: skin of chin
• Action: Elevates and protrudes lower lip
• Nerve supply: Mandibular branch of facial nerve (CN VII)
Oral Muscles - 6
6. Risorius
• Origin: Parotid fascia
• Insertion: Modiolus
• Action: Retracts angle of mouth (grinning)
• Nerve supply: Buccal branch of facial nerve (CN VII)
Oral muscle - 7
7. Zygomaticus Major and Minor
• Origin: zygomatic bone
• Insertion: Modiolus (Major) and upper lip (minor)
• Action: Elevates and retracts angle of mouth (smiling)
• Nerve supply: Zygomatic and buccal branches of facial nerve (CN VII)
Oral muscles - 8
4. Depressor anguli oris
• Origin: Mandible (oblique line)
• Insertion: Modiolus
• Action: depresses angle of mouth
• Nerve supply: Mandibular branch of facial nerve (CN VII)
Muscles of the Face
Others
1. Platysma
• Origin: Pectoral and deltoid fascia
• Insertion: Mandible, modiolus and lower face skin
• Action: Tenses neck skin, depresses mandible
• Nerve supply: cervical branch of facial nerve (CN VII)
Others - 2
2. Auricular muscles
• Origin: Mandible (oblique line)
• Insertion: Lower lip skin and orbicularis oris
• Action: depresses lower lip
• Nerve supply: Temporal and posterior auricular branches of facial
nerve (CN VII)
Nerve supply of the face
• Motor supply – Cranial nerve VII

• Sensory supply – Cranial nerve V

• The facial nerve is the primary motor nerve for the muscles of facial
expression. It also carries parasympathetic fibres (lacrimal,
submandibular and sublingual glands) and special sensory (taste)
from the anterior two thirds of the tongue.

• After exiting from the stylomastoid foramen, the facial nerve divides
into five terminal branches: temporal, zygomatic, buccal, mandibular
and cervical
Cranial nerve VII
• Temporal branch: Frontalis, Orbicularis oculi and corrugator supercilli,
procerus
• Zygomatic branch: Orbicularis oculi (palpebral part), zygomaticus
muscles, levator labii superioris
• Buccal branches: orbicularis oris, buccinator, nasalis, risorius, levator
anguli oris
• Marginal mandibular branches: Mentalis, depressor labi inferioris,
depressor anguli oris
• Cervical branches: Platysma
Motor Nerves of the Face
Sensory supply to the face
• The trigeminal nerve provides sensory innervation to the face via
ophthalmic, maxillary and mandibular divisions, except for the small area
over the angle of the mandible and the parotid gland which is supplied by
the great auricular nerve (C2 and 3).

• Ophthalmic division gives rise to supraorbital, supratrochlear and

nasocillary branches which supply the forehead, scalp, upper eyelid and
nasal bridge.

• The maxillary division gives rise to infraorbital and zygomaticotemporal

which supplies the cheek, lowe eyelid, upper lip and nasal alae
• The mandibular division gives rise to auriculotemporal, mental and
buccal branches which supply the lower lip, chin, temple and external
eat
Sensory Nerves of the Face
Sensory Nerves of the Face
Blood supply of the face
• The facial artery is the sole arterial supply to the face
• It hooks upwards over the inferior border of the
mandible at the anterior border of masseter
• Each superior and inferior labial artery runs across
the lip beneath and anastomose with the
corresponding artery of the opposite side.
• The forehead is supplied by the supraorbital and
supratrochlear arteries.
Facial artery
• Loops upward close to the outer surface of the pharynx and the tonsil
• Lies deep to the submandibular salivary gland
• Emerges and bends around the lower border of the mandible. It then ascends over the face
close to the anterior border of the masseter muscle
• Then ascends around the lateral margin of the mouth and terminates at the medial angle of
the eye
• Supplies tonsil, submandibular gland & muscles and skin of the face.
• Facial branches:
• Inferior labial artery
• Superior labial artery
• Lateral nasal branch to nasalis muscle
• Angular artery- terminal branch
Facial artery - 2
Veins of Face and Neck
• Facial vein
• Superficial temporal vein
• Maxillary vein
• Retromandibular vein
• External jugular vein
• Internal jugular vein
• Subclavian vein
Facial Vein
Formed at medial angle of
eye by
the union of supraorbital and
supratrochlear veins.
It joins anterior division of
retromandibular vein
 Superficial temporal Vein

Formed Formed on
the side of the scalp.
Enters parotid gland.
It joins maxillary
vein to form
Retromandibular
vein.
on the
Maxillary Vein
Formed in the Infratemporal fossa from the Pterygoid venous plexus.
It joins superficial temporal vein to form Retromandibular vein.
Retromandibular Vein
 Formed by the union of maxillary
vein and superficial temporal vein.
 Leaving parotid gland divides into
anterior branch and posterior
branch.
 Anterior branch joins facial vein.
 Posterior branch joins posterior
auricular vein to form external
jugular vein.
External jugular Vein
 Formed behind the angle of jaw by the
union of Posterior branch of
retromandibular vein with
posterior auricular vein.
 It drains into subclavian vein
 Tributaries:
 Posterior external jugular
 Transverse cervical
 Suprascapular
 Anterior jugular
Applied
• Trigeminal neuralgia
• Maxillary and mandibular nerve are involved
• Excruciating pain in the region of distribution of these nerve

• In infranuclear lesions of facial nerve (eg, bell’s palsy)- whole face is paralyzed
• Affected side is motionless
• Loss of wrinkles
• Eye cannot be closed
• In smiling the mouth is drawn to normal side
• During mastication food accumulates in vestibule of mouth
Facial nerve lesion ( Bell’s
palsy )